Private health insurance (PKV) – comparison-Germany

Private health insurance is comprehensive health insurance and is offered by more than 40 private insurance companies. In Germany, around 9 million people are privately insured because the private health insurance system offers a number of advantages. Private health insurance - for whom is it useful and for which professional groups is it particularly worthwhile? Performance differences between the providers as well as thousands of tariffs and tariff combinations make a comparison valuable in order to get the best insurance protection

advantages

Shorter waiting times

performance guarantee

individual tariff design

Contributions independent of income

Disadvantages

Families: each with their own contract

no return to statutory health insurance over the age of 55

Cures: Coverage depends on the tariff

Suitable for civil servants, the self-employed and students as well as for employees with an income of more than 62,550 euros (2020) per year (2021: 64,350 euros)

The premium varies depending on the benefits, age, occupation and state of health of the policyholder

For civil servants, the self-employed, students

For employees with income above

Private health insurance: Compare costs and benefits
At the beginning of 2009 , the legislature made compulsory health insurance compulsory. But most people have quite specific ideas about how best to protect their health. While statutory health insurance (GKV) leaves little room for manoeuvre, those with private health insurance have a clear advantage here: Above all, the benefits and the scope of insurance determine how much your own health insurance ultimately costs, along with your job, age and state of health.

As a general rule of thumb, the younger and healthier you are, the lower the premium for private health insurance.

How much does private health insurance cost?
First you have to decide which type of tariff you want to choose: The PKV offers several tariff variants and tariff classes, which often differ in the services and thus in the price. In addition to the compact tariffs , whose range of services is specified, there are also modular tariffs available. Individual building blocks can be put together individually and according to personal wishes . The price difference between tariffs and groups of people can amount to several hundred euros. Comparing the different offers is therefore very useful in order to secure the best value for money.

offer private patient status at a significantly lower price, with good services at least at the level of statutory health insurance
There is usually no provision for old age , but the deductible is higher
Amount for the self -employed from around 200 euros , for employees even from just under 150 euros (own contribution); Tariffs for civil servants correspond more to comfort and premium tariffs
offer extensive services at an often very good price-performance ratio
Price differences are often due to deviations in the amount of the deductible or reimbursements for other services
Contribution for the self-employed from around 265 euros ; for employees from just under 150 euros ; for civil servant candidates from just under 60 euros ; Officials from about 150 euros
offer the best medical treatment and cover the most comprehensive range of services, the price range is very high
Costs for the self- employed: from about  500 euros private health insurance contribution; Employees: almost  250 euros own contribution
Civil servant candidates and civil servants pay from around 65 euros or 170 euros , depending on the subsidy
should counteract increases in contributions in old age; with profit participation
constant contribution relief : fixed amount; Inflation & rising costs are ignored
dynamic: freely selectable sum with fixed annual intervals for increase; Compensation for inflation & premium increases
The amount of contributions in private health insurance is based not only on benefits but also on age. Depending on the provider and the tariff, the employee share for a 30-year-old privately insured employee can be between just under 150 and around 350 EUR. In the case of an older employee over 50 years of age, the personal contribution to the private health insurance costs will be significantly higher. At this age, a price range between almost 300 to around 650 EUR or even more is possible.*

*The price examples are inquiries from the insurers for healthy sample customers of the stated age without previous illnesses. The price may deviate from this for individual private health insurers. The following were requested: Allianz, Axa, Barmenia, Debeka, DKV, Central and Signal Iduna
The most important services in private insurance
The benefits in private health insurance are intended to guarantee basic health protection. In many cases, however, the care of private patients goes far beyond that: shorter waiting times, faster appointments with specialists, state-of-the-art medical treatment from the chief physician or accommodation in a single or double room are often part of a good private health insurance tariff. However, the services vary depending on the provider and by default

Important achievements

If the policyholder is ill for more than 43 days, the statutory continued payment of wages expires. In this case, private health insurance pays “daily sickness benefit”. In order to be able to effectively compensate for the loss of income, the daily sickness allowance should roughly correspond to the respective net salary.

Above all, the self-employed should pay attention to tariff benefits such as daily sickness benefits, since the statutory continued payment of wages does not apply to them and they have to take care of themselves in the event of illness. More about daily sickness benefit insurance

Anyone who needs inpatient treatment can freely choose the hospital in the PKV and receive the best possible treatment accordingly. Depending on the tariff, private health insurance enables better accommodation in the form of single or double rooms. In many cases, this is linked to the right to care from chief physicians and specialists. In general, privately insured persons do not have to pay co-payments for inpatient treatment.

In addition to the free choice of doctor, the outpatient services of the PKV often also include fast appointment allocation and shorter waiting times. In addition, prescribed medication and treatments are largely covered. Depending on the tariff, alternative services such as alternative practitioner costs can also be reimbursed. Many insurance companies also offer services for visual aids and aids as well as hearing and speaking devices.

In principle, according to the fee schedule for doctors (GOA), doctors' fees are covered by private health insurance companies up to 3.5 times the usual rate, good tariffs also cover higher rates. More about doctor's fees

Depending on the tariff, private health insurance includes extensive services for dentures and orthodontics. Depending on the tariff, up to 100% of the dental costs can be covered. For dentures, the reimbursement is between 60-80%. More on supplementary dental insurance

Since mental illnesses such as depression or burnout are becoming more common, consumers should consider including such services in their private health insurance when concluding a contract. In principle, psychotherapy is not regulated in the model conditions of the PKV association. In this context, the scope of services must be determined individually. Depending on the tariff and provider, the assumption of such costs can vary greatly.

Additional services

In order to save monthly contribution costs, a so-called deductible can be agreed upon when the contract is concluded. In the event of illness, the policyholder undertakes to bear part of the costs for the doctor and medication himself. In order for this to be worthwhile, however, the monthly contribution savings should be higher than the deductible itself. Chronically ill people should not be advised to share the costs, as the treatment services here are often very expensive.

While statutory health insurance generally does not cover naturopathic treatments, this is entirely possible with private health insurance – but only as an additional service. For example, if you want to be reimbursed for non-medical practitioner costs, you should take this into account when choosing a tariff. Before concluding the contract, the policyholder should also pay attention to the conditions and the amount of the costs to be covered. Some insurance companies limit their cost share to just 50-80 percent.

If a policyholder does not claim any services from his private health insurance for a year, he can receive a premium depending on the tariff. This is usually a monthly fee. Employees can even get up to 20% of their annual contribution refunded as a bonus. Benefits for co-insured children and young people under the age of 18 and preventive medical check-ups are not included.

The tariff option "refund of contributions in the event of a waiver of benefits" is usually binding for one year.

The assumption of costs for therapeutic cures is not covered by private health insurance. If you still want to claim this service for yourself, you have to secure it with an additional tariff. Policyholders can choose between various options when concluding the contract. The PKV often offers grants up to a maximum amount for spa costs. Insured persons can also have a “daily spa allowance” paid out to them. Payment is made depending on the daily rate per day of treatment. The self-employed can even deduct short-term additional tariffs from their private health insurance as “precautionary expenses”.

The prices for aids are not fixed, but reflect supply and demand. The costs are reimbursed according to what has been stipulated in the tariff conditions. For visual aids such as glasses or contact lenses, it is usually also precisely defined at what time intervals costs are covered and how high the amounts are in each case. If particularly expensive aids are to be used, prior consultation with private insurance is recommended. For example, there is often an option to rent expensive wheelchairs with a maintenance service. For other aids that can be obtained from the medical supply trade, a loan and assumption of costs is also an option - provided this has been clarified with the insurer in advance

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